How to obtain a state license for
your Home Health Care Agency?
Prepared by 21st Century Health Care Consultants – A Nationwide Company with 17 Years of Experience in the Licensing and Certification of Home health Care Agencies
Starting a home health business is a demanding task. Legal registration and permits for running the business are required, but the most demanding item is the submission of the required state application and preparation for the subsequent state license inspection. The owner also needs to plan out the services that are offered by the home health business for needing patients or the elderly.
Hiring a Home Health Care Consultant
Consider hiring a Home Care Consultant that is knowledgeable about setting up home health care agencies in your state. A good consultant can simplify the process and can expedite the licensing process, assure that you pass the state license inspection, train your personal on how to operate the agency and develop all the manuals that you will need in order to comply with state and federal laws.
21st Century Health Care Consultants prepares all license applications for its clients. It will typically provide a three hole binder which will include the license application itself and all required attachments an index will be provided as the front cover and the book in its entirety will be mailed to the client who will sign where indicated, attach a check for the license fee and mail the book in its entirety to the state authority. This approach organizes the application package for the person reviewing it and avoids the possible misplacement of documents by the person reviewing the application. Since 21st Century Health Care Consultants adopted this method the percentage of immediate approvals, without the need for corrections has increased to 90%.
The content of the licensure applications varies from state to state but there are always three common components:
- Proof of agency authorization must be provided
- Criminal Checks must be conducted, and
- Proof must be provided that key staff members (typically, Administrators and Director(s) of Nursing) are qualified under state regulations.
The amount of proof and the number of forms that states require to substantiate items 1-3 above varies greatly from state to state. Hence applications may be as short as five pages or as long at 55 pages.
Unless an applicant fails to sign the application or fails to provide the required fee, the application will not be sent back to the applicant. Instead, if the application is not filled out properly a letter of corrections or omissions will be sent to the applicant and the applicant will be given anywhere from 15 days to 30 days to make the corrections. If the state is not satisfied with the response the application will then be rejected.
The most common reason for an application rejection is that the state determines that either an Administrator or a Director of Nursing is not qualified to hold their positions. 21st Century Health Care Consultants will not allow a license application to be submitted unless we are certain that the staff members qualify.
Every state that requires a license application will also require a license inspection that will either be conducted by its own inspectors or by an Accrediting body. Eighteen states at present require that the licensure inspection take place before a license is issued. All other states will issue a provisional license or what is in effect a provisional license and then follow it up with an inspection visit.
The Chart below provides the following information: Whether or not license applications are accepted, what services can be provided under your license, whether a state application is required and if the license inspection takes place before or after a license is issued.
|States||Application Required||Programs Accepted||License Inspection|
|Alabama||Certificate of Need|
|Alaska||Yes||Priv Duty, Medicare, Medicaid||After licensure|
|Arizona||Yes||Priv Duty, Medicare, Medicaid||After Provisional License|
|Arkansas||Certificate of Need|
|California||Yes||Priv Duty, Medicare, Medi- Cal||Prior to license, by State|
|Colorado||Yes||Priv Duty, Medicare, Medi- Cal||Prior to license, by State|
|Connecticut||Yes||Priv Duty, Medicare, Medi- Cal||Prior to license, by State|
|Delaware||Yes||Priv Duty, Medicare, Medicaid|
|Florida||Yes||Priv Duty, Medicare, Medicaid||Prior to lic, by accrediting body|
|Georgia||Yes||Private Duty -Nursing only||Within 1 year after license|
|Hawaii||Certificate of Need|
|Idaho||Yes||Private Duty -Nursing only||“Desk Inspection -no visit- before licensure|
|Illinois||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|Indiana||Yes||Priv Duty, Medicare, Medicaid||Within 90 days after provisional license|
|Iowa||NO||Priv Duty, Medicare, Medicaid||None|
|Kansas||Yes||Priv Duty, Medicare, Medicaid||None|
|Kentucky||Certificate of Need|
|Louisiana||Certificate of Need|
|Maine||Yes||Priv Duty, Medicare, Medicaid||After License issued|
|Maryland||Yes||Priv Duty, Medicaid||Prior to license, by State|
|Massachusetts||NO||Priv Duty, Medicare, Medicaid||None|
|Michigan||NO||Priv Duty, Medicare, Medicaid||None|
|Minnesota||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|Missouri||Yes||Priv Duty, Medicare, Medicaid||Prior to license by accrediting body|
|Mississippi||Certificate of Need|
|Montana||Certificate of Need|
|Nebraska||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|Nevada||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|New Hampshire||Certificate of Need|
|New Jersey||Yes||Priv Duty and Medicaid||After License issued|
|New Mexico||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|New York||Yes||Priv Duty||Prior to license, by State|
|North Carolina||Certificate of Need||Priv Duty||Prior to license, by State|
|North Dakota||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|Ohio||NO||Priv Duty, Medicare, Medicaid||None|
|Oklahoma||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|Oregon||Yes||Priv Duty, Medicare, Medicaid||Prior to license, by State|
|Pennsylvania||Yes||Priv Duty, Medicare, Medicaid||2-3 months after license|
|Rhode Island||Certificate of Need|
|South Carolina||Certificate of Need|
|Tennessee||Certificate of Need|
|Texas||Yes||Priv Duty, Medicare, Medicaid||Required Six months after license|
|Utah||Yes||Priv Duty, Medicare, Medicaid||Prior to License|
|Vermont||Certificate of Need|
|Virginia||Open 07/01/2012||Priv Duty, Medicare, Medicaid||After License issued|
|Washington, D.C||Certificate of Need|
|Wisconsin||Yes||Priv Duty, Medicare, Medicaid||After Provisional license issued|
|Wyoming||Yes||Priv Duty, Medicare, Medicaid||After Provisional license issued|